Enhancing Care for Older People - Health Service Executive

As well as negotiating and explaining the observation procedures, it is also important to identify staff
beliefs and values, as a means of identifying the espoused beliefs and values of the team. Values
clarification is a complex and often lengthy process and in this phase it would be impossible to
undertake a values clarification to this extent. However, undertaking a values clarification as a
component of step 1 will enable you to understand the team’s values at a superficial level and provide
a benchmark for considering the data collected during the observations and how this relates to the
values that staff want to underpin their practice. In having this awareness, then feedback can be
structured (phase 4) in a way that is meaningful and less threatening. If the clinical setting does not
have an available set of clarified beliefs and The values WCCAT (such has as a been stated developed philosophy to help of care), people then involved you in the
will need to facilitate a values clarification process development with of team practice members to undertake about their observational practice – studies see of work
appendix 1 for a suggested values clarification place process settings and in also order refer to inform to Manley changes (2000 in practice. a), Wilson The tool is
(2005) or Workplace
Boomer at al (2006) for explanations suitable of the for process. use by anyone who has some experience of practice
development including the observation of practice. The tool has
been developed from an analysis of our experience of leading and
facilitating practice development programmes over many years.
Observation is one of the key tools used in emancipatory
Step 2: Preparing yourself to Observe practice development – a form of practice development that is
Culture
concerned with changing the culture and context of practice in order
In order to systematically gather detailed and to accurate develop information sustainable you person-centred (the observer) and need to evidence-based develop
specific skills in observation including the ability workplaces. to concentrate Seeing practice, in often raising busy consciousness environments, about to stand taken for
granted practices and reflecting on taken for granted assumptions
apart from the context you are observing and to defer any judgements you may wish to make about
are key components of comprehensive observation. This tool is
what you are observing. It is also important for you to take into account the role your own subjectivity
designed to help you develop a systematic approach to undertaking
plays in the observation process (Fawcett Critical
these 1996). activities. Whilst practice helps the observer obtain the
necessary skills, a deeper understanding of the intricacies We encourage of observation you to use is this developed tool and through would such welcome
things as group discussions, self directed learning your feedback and critical on reflection. its relevance and usability in your practice
development work.
The following practical guidelines (adapted from Contact Fawcett 1996) will assist you in preparing and
undertaking an observation using the Critical Analysis Brendan of Workplace McCormack: Culture bg.mccormack@ulster.ac.uk
Tool. The observation is
phase one Analysis
of the critical analysis and relates to what Liz is seen Henderson happening liz.henderson@bch.n-i.nhs.uk
in the clinical setting including
such things as the routines, the actions and interactions. for further The information. findings are used as a basis for critical
discussion with staff about what you have seen and heard, and how this connects to their experience
of practice.
Tool
Guideline Rationale
Preparing for
Observation
(1) What is the It is not possible to observe everything within a multi-sensory environment.
focus of the You need to choose a focus for your observation. You may be required to
observation
ORIGINAL
e.g.
AUTHORS
observe on a
OF
number
THE
of
WCCAT
occasions (at different time periods) to build up a
medication picture of what is happening in a workplace. You need to take into account the
o Brendan McCormack, Professor of Nursing Research University of Ulster and
administration environment, verbal and non verbal communication, actions, events & people
Director of Nursing Research and Practice development, Royal Hospitals Trust,
(2) How will Belfast. you It is helpful to develop a system for documenting your findings that enable
document o your Elizabeth you Henderson, to capture Lead data Cancer during the Nurse, observation Northern in a Ireland timely Cancer manner. Network. Consider what
findings?
o Dr Val Wilson,
abbreviations
Director
or
of
codes
Nursing
you
Research
may use
&
to
Practice
document
Development,
findings. Having
the Children's
large
margins allow you to capture your thoughts during and after the observation.
Hospital at You Westmead, will need NSW, to take Australia. note of things such as place/date/time (see the example
below)
o Jayne Wright, Research Associate, University of Ulster
(3) Gaining access
to the site
(4) Preparing
yourself
April 2007
You need to negotiate access to the site, think about us how often and how
long you might want to observe practice. You also need to inform staff about
the purpose of your observation and obtain consent where appropriate.
It is best to observe with a colleague in order to validate your findings and
agree on key issues. When choosing a partner for observation, consider the
Cultural Observation Tool version 5 – March 2007 6
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